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Maintaining tooth-implant distance following root amputation of a compromised adjacent tooth: A clinical case report
Bradley Lander1, Allison Rascon1, Dennis Sourvanos1,2
1Department of Periodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA.
Background:
Edentulous sites with limited horizontal tooth-implant distance pose a challenge to clinicians. This case report describes root amputation of an adjacent compromised molar to maintain an optimal tooth-implant distance METHODS AND RESULTS: A 41-year-old female was referred for extraction and implant placement to replace her left, maxillary second premolar (#13), which had been diagnosed with a vertical root fracture. Extraction and ridge preservation of #13 was completed without complication. The 4-month postsurgical clinical examination revealed a narrow mesial-distal distance (5.69 mm) of the edentulous space (#13), which was influenced by the degree of divergence of the mesial buccal root of tooth #14. Cone-beam computed tomography (CBCT) analysis verified a periapical lesion on the mesial-buccal root of tooth #14. The amputation of the endodontically compromised mesial-buccal root of #14 was treatment planned to provide space and facilitate placement of a standard diameter implant without compromising the implant or adjacent teeth. Crestal bone levels were verified and maintained at the 1 year postoperative follow-up.
Conclusion:
The findings of the case report demonstrate how root amputation of a compromised molar is an alternative solution for managing spatial limitations in contemporary implant dentistry. More studies are required to assess the reliability and long-term success of this approach.
Key Points:
Why is this case new information? There is insufficient evidence on the long-term efficacy of narrow-diameter implants. Clinical treatment guidelines are not sufficiently available. This paper presents an alternative approach to managing a specific scenario where mesial-distance distance is limited using root amputation of an adjacent compromised tooth. What are the keys to successful management of this case? Comprehensive diagnosis and stringent case selection Multidisciplinary treatment planning Evidence-based decision making What are the primary limitations to success in this case? Very specific clinical application; adjacent compromised tooth Long-term follow up is required.
